Need for ethical medical care
The contribution of various professionals towards society and country should be obvious. But not all professional activities can be put on the same footing although the services rendered by all professionals entail a high degree of responsibilities. For example, the medical profession is an outstanding case where flawless and very dedicated discharge of their duties by medical professionals are expected by people because the same involve their heath and lives, the most precious of human possessions.
Unfortunately, ethical conditions in the area of medical services continue to leave a lot desired in our country. This was stressed by a former President of the country on the occasion of the eleventh International Surgical Congress where he said that doctors in many cases prescribe unnecessary tests and take also unreasonable fees from patients. The President’s observations would be generally shared by a large number of people who fall ill and are exploited, thus, by members of a profession who are otherwise described as belonging to a noble profession of caring for sick persons.
It is seen that many doctors have an understanding with the numerous diagnostic centres that have cropped up in the country during the last couple of decades. Many of these so called diagnostic centres are not even properly registered or have licenses. Even some of the ones who have registration and licenses can be found on close examination to be seriously deficient in having appropriately trained and qualified doctors, technicians and other support staff. But incredibly they are successful in evading any kind of oversight actions from authorities whose job should be to regulate such deceitful and risky operations.
What is more concern raising is the often underhand relations between these centres and doctors. The doctors are prone to recommending such centres of their choice to patients. For every recommendation a part of the fee charged is reserved for the recommending doctor. Therefore, the temptation on the part of the doctors is to recommend a long list of tests for a single patient though only a few tests could be required. The patients can be doubly harmed from taking out tests in diagnostic centres of dubious value in the first place or even if they are recommended to centres with acceptable standards, from the compulsion to carry out unnecessary tests there.
The fee of a doctor with the basic MBBS degree for consultation in ordinary cases of cold, influenza, etc., should not be more than 50 taka. But the MBBS doctors in most cases are seen charging for writing out a prescription for say, common cold, not less than one hundred Taka. Some take a greater amount whilst the minimum consultation fee for a specialist doctor these days is 500 Taka. Hardly there are regulations in this field and doctors’ consultation fees are rising higher and higher all the time at the cost of their hapless patients.
The state of the public medical care system is not up to the expectation or need of many medical care seekers. It is shot through with corruption, lack of care and accountability. In these circumstances, patients have no other choice but to turn to ones who render medical services privately in the expectation of more dependable and effective treatment.
It is true that in recent years, world class private hospitals have been established in Dhaka. But these can be accessed by a limited number of the seekers of their services due to high costs. For the greatest number of ill persons of modest means, the reliance on the country’s less impressive privately run medical care facilities is total. But they remain prey to highly unethical activities of the above sort and do not get their money’s worth in many cases.
Thus, the challenge for the government is two-fold : to further improve services in the public medical system and, no less importantly, to engage in harder regulatory and supervisory activities to also much improve in all respects the privately offered medical care systems.
It is relevant to mention here that complaints are frequently made these days about production and marketing of sub standard drugs, completely fake drugs and about so called doctors practicing who never passed out from any proper medical institutions. The dangers posed to them for public health persuaded government’s health authorities to launch a crackdown against such offenders. A number of medical shops in the Mitford area of the city who indulge in such grave offences were raided by RAB, police and members of the government’s regulatory agency.
Indeed, their action could not have come any sooner because people’s lives and health were at stake. But in retaliation the owners of medical shops enforced shut downs of their shops pressing the government to pay compensation. So, they wanted the government to compensate them for its right actions and also to give a message that government must not attempt to punish them for their misdeeds and if it does then helpless users of medicines would be punished by denying them access to medicine as was done.
There is probably no such parallel of inhumanity to be noted elsewhere of the sort which the medicine shop owners showed through their most unconscionable behavior . Hundreds of thousands of people or patients with serious diseases suffered awfully for their most unconscientious attitude.
So, proper conduct in the entire realm of medical care must be ensured from end to end .